Improvement of oxygenation induced by aerosolized prostacyclin in a preterm infant with persistent pulmonary hypertension of the newborn.
OBJECTIVE
Case report on the effect of inhaled prostacyclin in a preterm infant (28 weeks gestational age) with respiratory distress syndrome complicated by marked hypoxemia due to persistent pulmonary hypertension of the newborn. Treatment with surfactant, hyperventilation, and elevation of systemic blood pressure had failed to improve oxygenation.


METHODS
A solution containing 10 micrograms PGI2/ml was aerosolized by the SPAG-2 aerosol-generator and then introduced into the afferent loop of the ventilatory circuit.


RESULTS
Oxygenation improved dramatically and worsened when aerosolization was withdrawn. Intravenous prostacyclin had no additional effect on oxygenation. We observed no side effects on blood pressure and no bleeding complications. Inhalation was stopped after 40 hours and the baby was successfully weaned from the ventilator after 108 hours.


CONCLUSIONS
Inhaled PGI2 had a beneficial effect on the oxygenation of a preterm neonate with persistent pulmonary hypertension of the newborn.
Soditt
V
V
Department of Pediatrics, Children's Hospital of the City of Cologne, Germany.
Aring
C
C
Groneck
P
P
D000280:Administration, Inhalation; D011464:Epoprostenol / Q000008:administration & dosage / Q000627:therapeutic use*; D006801:Humans; D000860:Hypoxia / Q000209:etiology; D007231:Infant, Newborn; D007234:Infant, Premature; D010547:Persistent Fetal Circulation Syndrome / Q000188:drug therapy*; D012127:Respiratory Distress Syndrome, Newborn / Q000150:complications*; D016896:Treatment Outcome; D014665:Vasodilator Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D015300:Ventilator Weaning
D014665:Vasodilator Agents; D011464:Epoprostenol